What do you know?

1. The Affordable Care Act: Outreach and the Impact on Youth and Young AdultsSCHA-MI 10th Anniversary ConferenceShanty Creek, MI2014 Robin Turner, SCHA-MIDizzy Warren, Michigan Consumers for Healthcare

2. Until what age may young adults stay on parents health coverage? When does Open Enrollment begin again? If a person was recently covered by employer based coverage, and loses their job, can they get coverage now? When was the Affordable Care Act enacted? What do you know?

3. Outpatient Care Emergency services Hospitalization Maternity and newborn care Mental Health and substance use services Prescriptions Rehabilitative and habilitative services and equipment Laboratory services Prevention and wellness, chronic disease Pediatric Essential Health BenefitsMust include the following

4. Families and individual receive tax credits to help pay their premium, depending upon income. Tax credits available to everyone between 133-400% of FPL. Tax credits are designed to keep premium costs between 2%-8% of income, on a sliding scale. Tax credits are refundable and advance-able. They are available on all metal plans. Premium Tax Credits (Subsidy)

5. Tax Subsidy • Average premiums, after subsidy were $82 per month • 85% of people applying for coverage through the Marketplace received a subsidy • Subsidies, if estimated too high or too low, are reconciled at tax time.

6. Cost Sharing Subsidies • For those under 250% of FPL, there are cost sharing reductions in the amount the client pays out of pocket. Only Silver plans (70% plans) may take advantage of this second tier of financial support. • $28,725 for an individual • $38,775, family of two • $58,875, family of four • $78,975 family of six

7. Metal Plans • Bronze – 60% • Silver – 70% • Gold – 80% • Platinum – 90% • Catastrophic – for young adults to age 29. Valued less than a Bronze plan, lowest premium. Deductible are very high.

8. Impact on Young Adults and Teens PRO CON Confidentiality issues when young adults stay on parents coverage, and EOB notices Messaging to youth and young adults about the “law of the land”. Need to be responsible for this now. Young people are very transient, with frequent income, housing, and relationship changes, including dependent changes. ALL of these affect how they are covered. • New coverage for over 4 million young adults staying on parents coverage to age 26. • Covered: contraception, prevention services (NO Co-pay), mental health services, substance abuse services • Pre-existing covered: HIV, STI, Pregnancy, Diabetes – no questions asked • HMP available to youth aged out of foster care • HMP available to non-pregnant persons, and men • Dental coverage • Can get catastrophic only coverage

9. Enrollment • Assisters -CAC’s (Certified Application Counselors) , 5 hours of training. Highly recommended for SBHC’s. -Navigators 20 hours of training, and responsible to not just enroll individuals, but also businesses, and to provide outreach.

10. Marketplace Enrollment

11. Find an Assister Enrollmichigan.com

12. The #1 reason people did NOT get covered in the first enrollment period was that THEY DID NOT KNOW WHERE TO GO FOR HELP. Your center can help by simply providing guidance to a place to get help! Outreach

13. Consider this….. • People were highly motivated by the deadline, hence the rush at the end. • People were also motivated by the penalty, especially young people. • Young people (ages 18-28) and latinos lacked knowledge about how to enroll. • People felt they just couldn’t afford it, so they didn’t inquire.

14. Difficult to Reach Populations • Men • Latinos and Hispanic • 38.7% uninsured, dropped to 37.0 after enrollment • Language and immigration issues • High health disparity • Other minority populations • 20.9% uninsured African Americans dropped to 17.6 after enrollment • High health disparity *Overall, 17% of Americans were uninsured before enrollment, 15.6 are now.

15. Become a CAC, have an in-house assister Put information about where they can go to enroll on your school’s website, and your own website. Hold an enrollment event, or health fair, during Open Enrollment Nov. 15 – Feb. 15, 2015 Send information home with back-to-school packets on BOTH the Marketplace, and Healthy MI Plan Create a display in your center during Open Enrollment Attend your school’s assemblies, Open Houses, etc. and share information Other ideas? Outreach Strategies for Your Center

16. Helpful Resources • SCHA-MI.org • Resources, ACA • Enroll Michigan - Find an assister, and other resources: • Enrollmichigan.com • Healthcare.gov • Center for Medicaid Services (CMS) • How to become a CAC and other resources for clients, including PPT: http://marketplace.cms.gov/training/get-training.html • Families USA • http://familiesusa.org/issues/affordable-care-act • Kaiser Family Foundation – great resources, hand-outs • www.kff.org/health-reform/ • Center for Adolescent Health and the Law • www.cahl.org

17. Contact Information • Dizzy L. Warren, Michigan Consumers for Healthcare: dizzy@consumersforhealthcare.org • Robin Turner, School-Community Health Alliance of Michigan rturner@scha-mi.org, turnerbird@aol.com, Phone: 517.908.0847, ext 222.